Aerosol-generating procedure

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An aerosol-generating procedure (AGP) is a medical or health-care procedure that results in the production of airborne particles (aerosols) or respiratory droplets, which may be pathogenic.

Aerosol-generating procedures include positive-pressure mechanical ventilation including BiPAP and continuous positive airway pressure (CPAP), high-frequency ventilation, tracheal intubation,[1] airway suction, tracheostomy, chest physiotherapy, nebuliser treatment, sputum induction, bronchoscopy[2] and ultrasonic scaling and root planing.

The term became popular during the 2003 SARS epidemic, where small retrospective studies showed a higher rate of infection amongst healthcare workers in which the procedures had been performed. However this has come under debate in the COVID-19 pandemic [3][4] and during this pandemic studies have been made that quantified the amount of aerosols produced by some AGPs and found that some AGPs generate less aerosols than a cough,[5][6][7] so some AGPs may not increase the risk significantly above that of a patient breathing or coughing normally but data is still lacking for many AGPs.


  1. ^ El-Boghdadly, K.; Wong, D. J. N.; Owen, R.; Neuman, M. D.; Pocock, S.; Carlisle, J. B.; Johnstone, C.; Andruszkiewicz, P.; Baker, P. A.; Biccard, B. M.; Bryson, G. L. (2020-06-09). "Risks to healthcare workers following tracheal intubation of patients with COVID-19: a prospective international multicentre cohort study". Anaesthesia. doi:10.1111/anae.15170. ISSN 1365-2044. PMID 32516833.
  2. ^ Tran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J (April 2012). "Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review". PLoS One. 7 (4): e35797. doi:10.1371/journal.pone.0035797. PMID 22563403.
  3. ^ Wilson, Nick; Corbett, Stephen; Tovey, Euan (2020). "Airborne transmission of covid-19". BMJ 2020;370:m3206. doi:10.1136/bmj.m3206. PMID 32819961.
  4. ^ Klompas, Michael; Baker, Meghan; Rhee, Chanu (2021-02-01). "What Is an Aerosol-Generating Procedure?". JAMA Surgery. 156 (2): 113. doi:10.1001/jamasurg.2020.6643. ISSN 2168-6254.
  5. ^ Nestor, C. C.; Wang, S.; Irwin, M. G. (2021). "Are tracheal intubation and extubation aerosol‐generating procedures?". Anaesthesia. 76 (2): 151–155. doi:10.1111/anae.15328. ISSN 0003-2409. PMC 7753480. PMID 33274761.
  6. ^ Brown, J.; Gregson, F. K. A.; Shrimpton, A.; Cook, T. M.; Bzdek, B. R.; Reid, J. P.; Pickering, A. E. (2021). "A quantitative evaluation of aerosol generation during tracheal intubation and extubation". Anaesthesia. 76 (2): 174–181. doi:10.1111/anae.15292. ISSN 0003-2409.
  7. ^ Dhillon, R. S.; Rowin, W. A.; Humphries, R. S.; Kevin, K.; Ward, J. D.; Phan, T. D.; Nguyen, L. V.; Wynne, D. D.; Scott, D. A.; the Clinical Aerosolisation Study Group; Yule, A. (2021). "Aerosolisation during tracheal intubation and extubation in an operating theatre setting". Anaesthesia. 76 (2): 182–188. doi:10.1111/anae.15301. ISSN 0003-2409. PMC 7675280. PMID 33047327.